Summary

7 facilities within 25 miles of Roanoke publish prices for Prostate Biopsy. Cash prices range from $1,523 to $17,215 — a 11.3x difference for an identical procedure. The Virginia average is $5,230.

$1,523 lowest
$17,215 highest
Best Value

Carilion New River Valley Medical Center

Christiansburg, VA · Carilion Clinic · 0.1 mi

$1,523 Cash price
4/5 CMS rating
69.0% Patient satisfaction

Lowest price among hospitals rated 4 stars or above. Patient satisfaction: 69%. Cash price of $1,523 is below the statewide average of $5,230.

All facilities ranked by price

1
Carilion New River Valley Medical Center 4★ · 0.1 mi · Nonprofit
$1,523
2
Sentara Halifax Regional Hospital 3★ · 0.1 mi · Nonprofit
$1,568
3
Carilion Giles Community Hospital 4★ · 0.1 mi · Nonprofit
$4,356
4
Carilion Medical Center 4★ · 0.0 mi · Nonprofit
$4,356
5
Sovah Health Danville 2★ · 0.1 mi · For-profit
$7,812
6
Carilion Stonewall Jackson Hospital 3★ · 0.1 mi · Nonprofit
$17,215
Complete facility data
# Facility Cash Price Gross Charge Markup CMS Stars Patient Rating Ownership
1 Carilion New River Valley Medical Center Carilion Clinic Christiansburg, VA · 0.1 mi $1,523 $2,539 1.67x 4/5 69.0% Nonprofit
2 Sentara Halifax Regional Hospital Sentara Health South Boston, VA · 0.1 mi $1,568 $3,137 2.0x 3/5 71.0% Nonprofit
3 Carilion Giles Community Hospital Carilion Clinic Pearisburg, VA · 0.1 mi $4,356 $7,260 1.67x 4/5 83.0% Nonprofit
4 Carilion Medical Center Carilion Clinic Roanoke, VA · 0.0 mi $4,356 $7,260 1.67x 4/5 66.0% Nonprofit
5 Sovah Health Danville Danville, VA · 0.1 mi $7,812 $19,529 2.5x 2/5 59.0% For-profit
6 Carilion Stonewall Jackson Hospital Carilion Clinic Lexington, VA · 0.1 mi $17,215 $28,691 1.67x 3/5 75.0% Nonprofit
7 Lewisgale Medical Center HCA Virginia Salem, VA · 0.1 mi 2/5 57.0% For-profit

Insurance negotiated rates by facility

The rates below are what each insurer has contractually agreed to pay this hospital for Prostate Biopsy. Your actual out-of-pocket cost depends on your deductible status and copay structure.

Carilion New River Valley Medical Center

Cash: $1,523
Insurance Plan Negotiated Rate vs Cash
Anthem Managed Medicaid $216 -$1,308
Sentara Health Plan Managed Medicaid $220 -$1,304
Humana Managed Medicaid $226 -$1,297
ABH of VA (formerly Coventry) Managed Medicaid $226 -$1,297
UnitedHealthcare Managed Medicaid $226 -$1,297
Aetna Choice POS II $1,318 -$206
Sentara Health Plan Commercial $1,574 +$51
VHN - ULTRA Commercial $1,574 +$51
Cigna Commercial $1,711 +$188
Aetna Medicare Advantage $1,732 +$209
Connecticare Commercial $1,777 +$254
Humana Dual Eligible $1,806 +$282
Humana Tricare $1,810 +$287
UnitedHealthcare Medicare Advantage $1,879 +$356

15 additional plans not shown.

Carilion Giles Community Hospital

Cash: $4,356
Insurance Plan Negotiated Rate vs Cash
Anthem Managed Medicaid $216 -$4,140
Sentara Health Plan Managed Medicaid $220 -$4,136
Humana Managed Medicaid $226 -$4,130
UnitedHealthcare Managed Medicaid $226 -$4,130
ABH of VA (formerly Coventry) Managed Medicaid $226 -$4,130
Humana Dual Eligible $1,806 -$2,550
Humana Tricare $1,810 -$2,546
Humana Medicare Advantage $1,879 -$2,477
UnitedHealthcare Medicare Advantage $1,879 -$2,477
Anthem Medicare Advantage $1,898 -$2,458
Aetna Medicare Advantage $1,898 -$2,458
Sentara Health Plan Medicare Advantage $1,935 -$2,421
Aetna Exchange $3,485 -$871
Aetna Commercial $3,695 -$661

15 additional plans not shown.

Carilion Medical Center

Cash: $4,356
Insurance Plan Negotiated Rate vs Cash
Anthem Managed Medicaid $216 -$4,140
Sentara Health Plan Managed Medicaid $220 -$4,136
ABH of VA (formerly Coventry) Managed Medicaid $226 -$4,130
UnitedHealthcare Managed Medicaid $226 -$4,130
Humana Managed Medicaid $226 -$4,130
Humana Dual Eligible $1,806 -$2,550
Humana Tricare $1,810 -$2,546
Humana Medicare Advantage $1,879 -$2,477
UnitedHealthcare Medicare Advantage $1,879 -$2,477
Anthem Medicare Advantage $1,898 -$2,458
Aetna Medicare Advantage $1,898 -$2,458
Sentara Health Plan Medicare Advantage $1,935 -$2,421
Aetna Exchange $3,485 -$871
Aetna Commercial $3,695 -$661

15 additional plans not shown.

Carilion Stonewall Jackson Hospital

Cash: $17,215
Insurance Plan Negotiated Rate vs Cash
Medicaid Traditional Medicaid $208 -$17,006
Virginia Premier - CCC Plus CCC Plus $208 -$17,006
Virginia Premier Managed Medicaid $214 -$17,001
HealthKeepers Plus Managed Medicaid $219 -$16,996
Aetna Managed Medicaid $229 -$16,985
Community Plan Managed Medicaid $229 -$16,985
Intotal Health Managed Medicaid $229 -$16,985
Magellan Complete Care Managed Medicaid $229 -$16,985
Magellan Complete Care MLTSS/CCC+ $229 -$16,985
Medicaid Managed Medicaid $229 -$16,985
Humana Dual Eligible $1,757 -$15,457
Humana Medicare Advantage $1,793 -$15,422
Medicare Traditional Medicare $1,793 -$15,422
Anthem Medicare Advantage $1,883 -$15,332

18 additional plans not shown.

Lewisgale Medical Center

Cash: N/A
Insurance Plan Negotiated Rate
Anthem HIX $4,104
Anthem HMO $4,561
Anthem PPO $4,561
Optima Health HMO $4,845
Optima Health POS $4,845
Optima Health PPO $4,845

Before you call

The data in this report is from each hospital's publicly filed prices. Here's how to use it.

Confirm the price

Call the hospital's billing department and ask for a price estimate or Good Faith Estimate for Prostate Biopsy (CPT 55700). Under federal law, they must provide this. Compare it to the published price in this report.

Ask about cash pay

If you haven't met your deductible, ask for the cash/self-pay rate. At many hospitals, the cash price is lower than the insurance-negotiated rate. You can see this in the insurance table above — some negotiated rates exceed the cash price.

Compare before you schedule

You are not required to use the facility your doctor referred you to. You can request a referral to any in-network facility. The same procedure, same quality — sometimes at a fraction of the price.

Ask about financial help

Most nonprofit hospitals in Virginia offer financial assistance to patients based on household income. This is separate from insurance — even insured patients can qualify. Ask billing for their Financial Assistance Policy.

Financial assistance by facility

Nonprofit hospitals are legally required to have financial assistance programs. Below is what we know about each facility's charitable care.

Facility Status Charity Care Provided How to Apply
Carilion New River Valley Medical Center Nonprofit Call billing, request Financial Assistance application
Sentara Halifax Regional Hospital Nonprofit Call billing, request Financial Assistance application
Carilion Giles Community Hospital Nonprofit Call billing, request Financial Assistance application
Carilion Medical Center Nonprofit Call billing, request Financial Assistance application
Sovah Health Danville For-profit N/A (for-profit)
Carilion Stonewall Jackson Hospital Nonprofit Call billing, request Financial Assistance application
Lewisgale Medical Center For-profit N/A (for-profit)

What to do next

  1. Identify your top 2-3 facilities based on price, quality rating, and distance. The data in this report shows that lower price does not mean lower quality — check the star ratings.
  2. Call billing before you schedule. Confirm the published price. Ask for a Good Faith Estimate. Ask whether there's a prompt-pay or cash-pay discount beyond the listed rate.
  3. Check your deductible status. If you haven't met your deductible, compare the cash rate to what you'd owe through insurance. In some cases, paying cash is cheaper than using your plan.
  4. Apply for financial assistance if your household income is under $60,000-$125,000 (thresholds vary). Most eligible patients never apply because they don't know the program exists.
  5. Get everything in writing. Before your procedure, get a written price estimate. After, review the bill line by line. Roughly 80% of hospital bills contain errors (Becker's Hospital Review).

Data sources

Hospital prices
Published machine-readable files, required under CMS Hospital Price Transparency Rule (45 CFR Part 180)
Quality ratings
CMS Hospital Compare, updated quarterly
Patient satisfaction
HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems)
Financial data
CMS Cost Reports (charity care, revenue) and IRS 990 filings (officer compensation)

This report is for informational purposes only. It is not medical advice. Every price shown is a price a hospital published — not an estimate. Actual out-of-pocket costs depend on your insurance plan, deductible status, and clinical circumstances. Consult your healthcare provider and insurer before making decisions.